by Maeve Binchy
I wasn’t very elegant. I never learned to make smoke rings. There was a lot of ash on my chest, little burns in my tights and I was forever making loud, unpleasant throat-clearing sounds. I fell into habits I had once found disgusting in others, such as crushing butts out in the empty grapefruit rinds on breakfast plates. But what the hell. I was a smoker, and all that sort of thing goes with the territory.
And then, in 1978, there was a bad flu in England. As I lay in bed with a pain in my chest, red-eyed and very self-pitying, I heard a newsreader on the radio say, in tones that managed to be both doom-laden and urgent at the same time, that all over the country, the flu had turned to pneumonia in heavy smokers. Panic-stricken, I leaped from the bed and went to the surgery.
The waiting room was so full that patients were standing in lines around the wall, all of us spluttering and clutching our chests. When my turn came the doctor looked up wearily. It had been a long morning.
He tried to put some sympathy into his greeting to what may have been the ninetieth person who had sneezed on top of him in the last two hours.
‘Flu?’ he suggested.
‘Pneumonia,’ I corrected. ‘It’s pneumonia, I heard it on the radio.’
Doctors often get patients who have heard messages from the radio or outer space. They are time-consuming people. He looked at me sadly.
‘Oh dear,’ he said.
I was desperate at this stage. ‘Doctor,’ I implored, ‘I would be the last person to think of mentioning the British Medical Council, but are you or are you not going to listen to my chest?’
In the background, the 150 or so meek and obedient people who would have readily accepted they had flu barked like poor sick seals in the waiting room. To humour me, and mainly to get rid of me, he took out his stethoscope and plonked it in the area of my lungs.
‘Breathe in,’ he said through clenched teeth.
I did and the pain was desperate.
‘What do you hear?’ I croaked.
‘I hear that you are fat, you are forty and you smoke five packs of cigarettes a day,’ he said as he wrote a prescription for antibiotics to deal with post-flu infections.
He was three years on the wrong side of my age, of course, which was fairly offensive. But he was right otherwise.
‘You mean the pain has to do with smoking?’ I asked in disbelief.
‘Oh yes, indeed,’ he said and rang the bell for the next patient.
And just because it was all so obvious to him, and because he didn’t even try to make me give them up, some kind of scales fell from my poor red eyes and to this day I have never smoked another cigarette.
AIR CONDITIONING
Your nose is busy cleaning, warming and humidifying more than 500 cubic feet of air each day.
AGEING HIPPY
If you have to have a new hip, believe me nobody will ever tell you about it as straight as I will.
No technical jargon. No ludicrous, perfectionist advice about keeping fit. Just the facts, explained both simply and graphically.
Hips rot away. I don’t know exactly why … sometimes it’s congenital, sometimes as a result of an injury … but anyway, when the ball-and-socket joint that sort of sticks your leg to the trunk of your body starts to decay you feel terrible.
Now don’t let anyone get away with the words ‘a touch of arthritis’. It’s much, much worse. It’s as if somebody accidentally left a carving knife in your groin and nobody took it out. And yet somehow, to those who don’t know how bad it is, it’s seen as some vague rheumaticky sort of ache, originating somewhere mainly in the mind.
It gets worse. You can’t walk, you can’t stand, you can’t sleep. You are old before your time, and you can’t go out into the streets and cry aloud how really badly you feel or they will think you are mad as well as rheumaticky.
So you go to a doctor who sends you to get X-rays, and if they show that your hip is in bits, be pleased rather than upset. That means they can do something about it.
Then you see an orthopaedic surgeon, who, if you are lucky, will agree to give you a new hip. This is the moment where you really and truly need my advice. It’s in three simple words. Go for it.
This is an operation with a huge success rate. You will wake up and the pain has not only gone … it stays gone.
Let me tell you my story.
I was the fattest patient the surgeon had ever met, and he said that even though he could see my poor hip was in smithereens, honestly, I was so fat that if he did my hip I would die on the operating table. If I lost the weight, he said he would think again.
I lost the weight. It was really only possible because I had the carrot of a pain-free life dangling in front of me. I then heard the words that I was to come in for the operation.
I was so excited at first I told everyone. And I was delighted, but of course in the long reaches of the night I wondered was I mad. Fortunately, there wasn’t too much time to brood before I was in there, lying rigid with terror in a hospital bed in my purple nightie.
They sort of go over you the night before an operation to make sure you are a reasonable risk. Everyone is very cheery and matter-of-fact and you sign things about knowing what’s involved, and naming your next of kin, and then they say good night.
During the night I got this sudden insight. The insight was that I was mad to be having a new hip, I was fine as I was. So I couldn’t sleep, walk, stand, work, think, enjoy anything, but basically I was fine. I must have over-exaggerated my symptoms.
I must go home now, I thought, and crawled out of bed, and found my two walking sticks and my coat.
I had got as far as the door when the nurse came in and guided me firmly back to bed. Lots of people do this, according to the nurse. It’s called a night hallucination. I lay there glumly until the trolley came.
They don’t give you a tranquilliser as I had thought, so you go down quite awake. The operating theatre looked like something from a television series.
I am a person who thinks that something should be said on every occasion. ‘I think I’ll leave it all to you,’ I said to the surgeon, and they all seemed deeply relieved.
It was an epidural injection, the kind that people often have in labour. I was very afraid I would be awake for it all, and know what they were doing, and try to stop them. But no, completely the reverse. I must have had some kind of nice relaxing drug somewhere along the line, because not only did I feel nothing but also I didn’t know where I was.
I thought I was in a hotel, entertaining this group of people around my couch. I talked non-stop for whatever number of hours it took. I said I was so sorry that I had chosen a place with such heavy building going on, all that drilling and hammering, but then, on the other hand, you had to be grateful there was so much building industry going on these days. I had absolutely no idea that the drilling and hammering was all on my own leg.
Then, after a day in Intensive Care, where apparently I wanted to know the full words of ‘They Can’t Take that Away from Me’ and sang tunelessly the bits I remembered, they tell me I was brought back to my own bed and I realised the pain was gone.
So you say it can’t be so easy? It is. Why would I lie to you?
In my own case, I had horrible, weak, rotten bones, so it took me a bit longer to get out of bed than the rest of my ward. But I was never competitive.
And there were some amazing things that followed:
… like not being allowed to sleep on your side. There was a horrible contraption in the bed to stop you doing that.
… like the fact that you didn’t seem to own your new hip; it was always referred to as the surgeon’s new hip.
… like you had to slide his hip to the side of the bed before standing up, or lay his hip carefully on a strange triangular cushion for chairs, or position his hip over a high seat on the lavatory.
… like the really revolting elastic stockings.
… like not being allowed to sit up in bed on your own by moving your bum; instead
you had to drag yourself up by this extraordinary gadget that hung over the bed and was meant to develop your arm muscles, I suppose. For those who used it, I suppose it did.
I just snuggled down and read more and more books. Then I was cured and went home.
I am no role model for anyone. I did not do all the horrific exercise they demanded. I just hate the thought of my lungs filling up with all that air and oxygen and everything if it means I have to walk vigorously every day.
But for more than two years I have had no pain whatsoever. I can manage stairs and airports and corridors and I have sleep-filled nights. To me this is reward enough to make me advise anyone else to have the operation.
I know that when my next hip needs replacing I will go in there like a lamb. I will always celebrate the leap of faith in those who knew that arthritis was not just malingering. It was debilitating, destructive and not at all part of a so-called natural ageing process. Their foresight and skills in this area will be forever celebrated.
SOME AMAZINGLY FATTENING
THINGS TO EAT
Fried bread
Roast goose with a lot of skin
Tiramisu
Peanut butter sandwich with banana and jam
Sausage roll
Digestive biscuits almost hidden by pâté
Any dessert called ‘Special Chocolate Plate’
WHEN IT IS REALLY SERIOUS
I had a friend who was told out of a clear blue sky that he had only three more months to live. Since he was someone who had a fair chance of about twenty or even thirty more years, the shock for him and his many friends was overwhelming.
But he was the one who handled it extremely well, it was the friends who floundered. Some were literally unable to face it at all. They feared going to see him lest they break down and make things worse, if that were possible.
Some came with false hopes and cures. There was much confident talk of the power of crystals, the hands of a healer, the lichen that grew on some rock in the desert. Some came with stories of magnificent surgeons in this city or in that medical centre.
Some sent holding letters, full of vague generalities about not losing hope and promising a visit they never intended to make. Some – and these, he found, were the saddest – sent him little Get Well cards with pictures of bunny rabbits weeping into a handkerchief and saying ‘So sorry to hear that you’re sick’.
The other kind of card he got fairly regularly was a jolly vulgar one, with sexual innuendo or bedpan humour and cheerful bluff messages inside saying something like ‘Come on now, mate, we are counting on you to beat this’.
And as he lived out his three months calmly he did not rail against those with the inability to say goodbye. He said that until it happened to him he would have done more or less the same, apart from the bunnies crying into the handkerchiefs.
He said that he wasn’t at all living twenty-four hours a day in fear and terror of what will, in any event, happen to us all sometime, but in his particular case would happen within a given and short period of time. Having some notice gave you a chance to take stock, he said, and forced you to do those things you had been intending to do for years.
He went to see the Grand Canyon, and stood and watched three magical sunsets there without self-pity because even without his diagnosis, he said, he would probably not have gone back again anyway. He tidied up all his affairs, wrote to public figures whom he had admired. He gave his books and pictures away to people who might like them.
He was low sometimes, but never frightened, and he claimed that he didn’t waste one of his eighty-four days on useless regrets. He said the very best thing people could do for him was to visit him at home and give the one obligatory acknowledgement of regret that he was about to die so soon. He said you needed that much, otherwise the conversation was entirely artificial and everyone was in some kind of denial. After that you left it.
He loved people to talk about the world that he had lived in, the people they knew, the social beliefs they had shared or argued over, the successes, the failures, the near disasters, the funny things that had happened along the way, the amount of the twentieth century they had seen together, with all the changes for good and not for good.
He liked the glamorous fifty-something woman who claimed she had always fancied him, safe enough to say now that it was too late, and the tough, pushy businessman who invented a mythical reason to be in the area and came along to learn a three card trick. He told my friend he needed to know how to do ‘Find the Lady’ before the secret was gone forever.
As for the people who really couldn’t visit because of the distance … well, it would be great if they could telephone or write a letter, a proper letter, rather than hiding behind a greeting card, he said. Nothing emotional or weepy, but something that might make sense of a life lived and now ending. He said there were some amongst his friends who could do this, but not enough. And he liked to hear that there would be a tree planted here and a rose bush there for him.
He missed the many people that he knew had liked him greatly and were crying for him, and for whom he was already dead because he was no longer in their lives as someone full of hope and future. Unless you are a king in a fairytale, you can’t summon people to your deathbed, but he wished they had come.
His story isn’t everyone’s story, but it just might be many people’s. And at least it might make us think twice before automatically reaching for the excuse or worse, a card that purports to say it all and only says we ourselves have no real words of friendship left to offer.
IN AN IDEAL WORLD …
In an ideal world every patient would be a twinkling, smiling, grateful person propped up with pillows, overcome with gratitude that we have come to visit.
The perfect patient’s face will crack open into a huge smile of delight as if no other person on earth could possibly be as welcome as we are. There will be nice fresh fruit on offer, a few chocolate truffles, maybe even books or magazines to lend us because they have already been read and it would be a kindness, really, to clear space in the bedside locker.
Ideally the patient will have no complaints about anything, the prognosis is good, the doctors are inspired, the nurses are angels and the hospital food is fine.
We’d all go hospital visiting if only we could be sure the patients were going to be like that. But there are days when we approach a bed and know that its going to be far from ideal.
I was in a hospital ward and heard a woman greet her daughter who had come in by a horrific journey involving one train and two buses. The mother’s first words were that she need not bother to come in again wearing that short skirt and looking like a tart.
I saw a man welcome his white-faced, anxious wife during visiting time by saying that she had yet again brought the wrong sporting paper and was there a chance that one day she might get something right.
I once went to see a fairly feisty, elderly woman who decided that she would prefer to go to sleep than talk to me. Sleep, she explained was one of the few pleasures she had left to her and that she felt a wave of it coming over her at that moment, she was sure I would understand.
I have seen a three-year-old boy coming in to a maternity ward clutching flowers for his mother and what does he find but that she’s cradling and cooing over a small screaming, red-faced baby, with no similar hugs for himself. And on top of all this he is meant to be pleased that this horrible thing has joined the family.
And in this perfect world every patient would look out of bed and see a regular stream of delightful, concerned visitors coming to see them carrying exactly the right gift. These ideal visitors would want to know the most detailed minutiae of every happening since they last visited. They would be fascinated by any change in medication, temperature charts, blood pressure levels. They would beg for details of what the consultant said, what the house-man identified and whether the nurse taking blood had found a good sturdy vein. They would remember the names of every single member of staff that had
been mentioned. They would bring warm personal greetings from almost everyone in the outer world and give the impression that society as we know it had almost broken down because of the patient’s temporary absence in hospital.
But of course that’s not going to happen for the poor patient either. It’s a far from perfect world.
I must explain that I am an avid reader of self-help books. I have shelves of them at home. I truly think that almost everything can be learned from a manual. But if you have hundreds of manuals, as I do, about topics such as how to flatten your stomach, have perfect skin, thrive on stress, play demon bridge or cook with yeast, then you will realise that if you get one single piece of useful information from any manual then you are doing well.
Wendy Shea and I, hopeless but caring and cheerful patients and well meaning hospital visitors in turn, wish just that there may have been something in these pages that made you believe that things weren’t quite as bad as you thought they would be. Just this one small insight is all we want for you. Then it will have been worth while writing and illustrating this bossy little book.
AN ORION EBOOK
First published in Great Britain in 1999 by Orion.
This eBook first published in 2010 by Orion Books.
Copyright © Maeve Binchy 1999
Copyright © Maeve Binchy 1999
The rights of Maeve Binchy to be identified as the author of this work has been asserted by her in accordance with the copyright, designs and patents act 1988.
All characters and events in this publication are fictitious and any resemblance to real persons, living or dead, is purely coincidental.